Steven Waldman

Does The Likelihood of Early Infant Death Make Late Term Abortions More Justifiable?

In response to the assassination of George Tiller, a number of blogs have posted testimonials from women who had late term abortions. Poignantly, most of the women wanted the babies. In some cases, the babies were dead or dying within the womb. Hilzoy has several examples at The Washington Monthly.
One woman in the eighth month found out that she had conjoined twins. One of the twins had died. And the other was unlikely to survive:

“At best only one child would survive the surgery to separate them and the survivor would more than likely live a brief and painful life filled with surgery and organ transplants. We were advised that our options were to deliver into the world a child who’s life would be filled with horrible pain and suffering or fly out to Wichita Kansas and to terminate the pregnancy under the direction of Dr. George Tiller.”

Another woman discovered that one of her twins had died and that delivering the other would likely have killed her.
One who couldn’t find a doctor to do a late term abortion — even though the baby was already dead in the womb.
Another twice opted for a “partial birth” abortions after learning the babies had “no faces, with no way to eat or breathe,” and would die almost immediately after birth.
I hadn’t realized that. We so often talk about the issue being the “life or health” of the mother. But it sounds like sometimes the issue is that the baby is already dying or will die soon after birth. In that sense, some partial birth abortions are more like euthenasia or a mercy killing — still a difficult ethical dilemma but not exactly the same as heartless homocide. I have no idea how many late term abortions fit into this category.
Why don’t we talk about this as a criterion for late term abortions? It seems that the most humane approach would be to ban the procedures unless not doing it would endanger the life of the mother, lead to serious health risks and/or if there’s a high likelihood that the baby would die within the first weeks anyway.
I put “and/or” because I’m not sure whether likely infant death by itself should be justification. If the baby is going to die but giving birth poses no risk to the mother, it may be that the law needs to, reluctantly, err on the side of fetus. (And what about the babies that could survive a few years but would be in continuous pain? What should the law say about that?)
What’s also clear from these stories is that some babies would survive but be in constant pain, draw huge medical bills and inflict incredible trauma on the parents. So here’s another potential area of common ground: pro-life and pro-choice groups should band together to raise money (or pass a law) to pay those medical bills and emotional support for families that end up in that situation. And volunteers should work to help that family through the ordeal.
Hilzoy offered these stories as a defense of Tiller and, presumably, to reinforce the argument that it should be a woman’s right to make this horrible choice. But I’m not sure they prove the latter. In these stories, the medical conditions were such that bringing in a second doctor to validate the recommendation of an abortion provider would not have changed the outcome. In other words, with a properly crafted late term abortion ban, these would still be allowed.
UPDATE: Another poignant example provided by Andrew Sullivan. A couple was told their baby had anencephaly,- a condition where the fetus’ skull does not completely close:

“The babyThey were told the child would die before, or shortly after, birth…It was an agonizing decision, but they chose not to have the abortion for religious reasons. The pregnancy went to term and the baby lived for several weeks.
Imagine what it is like to walk around in your third trimester, obviously pregnant, while well-meaning people ask you about this baby that you don’t expect to be taking home from the hospital… Then imagine the baby survives and days later you take home this child who will die. In case you might relax and pretend for a little while that everything is okay, a hospice nurse comes to your house every couple of days and reminds you the signs and symptoms of death. Every time you open the refrigerator you see the narcotics you’ve been given to ease the baby’s suffering once things get really bad.”
Eventually, this baby dies a grueling death in your arms and you go home to an empty house….”

Sorry to be so harsh, but you make an incredibly ignorant statement when you write “I hadn’t realized that” women have (late term) abortions because it’s only then that they are able to learn of the horrible problems their (much wanted) children are developing. The pro-life movement has done a great job of spreading the lie that women are aborting their 8.5 month pregnancies because they only want to fit into a prom dress or swimsuit.

@Connie: Actually, I really hadn’t been aware of the number of late-term abortions that happen because of such horrible congenital defects until Andrew Sullivan started posting the stories yesterday on his blog either. The pro-life movement, as you correctly point out, has done a good job of claiming that late-term abortions are for purely craven reasons. Meanwhile the pro-choice movement focuses on the life/health of the mother. No one, it seems, has been talking about the need for late-term abortions where either the unborn child is already dead in utero, or the unborn child will face an extremely short, painful, traumatic life due to the severity of its condition.

Someone on another blog said the following came from Dr. Tiller’s website:
” Admission Criteria
In order to offer you an appointment, we require that a physician refer you to our center. In addition, we need your genetic counselor or doctor to provide us with gestational and diagnostic information regarding your pregnancy. Over the past twenty-five years, we have had experience with pregnancy terminations in such situations as anencephaly, Trisomy 13, 18, and 21, polycystic kidney disease, spina bifida, hydrocephalus, Potter’s syndrome, lethal dwarfism, holoprosencephaly, anterior and posterior encephalocele, non-immune hydrops, and a variety of other very significant abnormalities.”
The abortions Dr. Tiller performed are not black and white for everyone.
The killer’s associations:http://www.kansas.com/news/tiller/story/834448.html
The killer has associated with ant-government groups and anti-abortion.

The harsh truth is that is it very, very difficult to have an explicit conversation about what to do when the child you are having is not the child you wanted. And I’m not talking about sex selection.
Pro-choice people are understandably squeamish about having a forthright discussion about this. Pro-lifers, on the other hand, find it easy to say “have the baby no matter what,” when they aren’t the ones who have to suffer emotionally and financially to care for it.
Admire the families who have and care for these children for their short, painful lives, but don’t make that be the only choice for every family facing those situations. Andrew Sullivan and Hilzoy have posted some of the most tragic histories of women who have chosen abortion and volunteered their stories. Thankfully, due to medical privacy, we don’t have to get this level of detail for every woman who choses a late term abortion.
Some pro-lifers will MAYBE, reluctantly, accept/allow early induction of labor or a C-section in these hard cases, knowing the child will soon die but somehow that’s better, in their eyes, than being dismembered or having its brains sucked out in the womb, regardless of how difficult the labor/delivery or C-section is for the woman.
We’ve gotten used to both sides of the discussion around rape, incest, life/health of the mother hard cases. The I-don’t-want-THIS-child, or I-don’t-think-my-child-should-live-the-sad-life-it-will-have discussion is carefully avoided by both sides.

My wife gave birth to a beautiful anencephalic little boy about seven weeks ago. He lived for the most wonderful 16 days we’ve ever had. We knew he wouldn’t live long, but we couldn’t be more grateful for his life. We were not only given the gift of getting to know our son, but we were given the blessing of true grief over the loss of our son. Had we chosen to do it differently, I’m sure we’d have always had a knot in our stomach about it and have never enjoyed the overwhelming joy that those 2 weeks with our son were. We’re starting to (slowly) blog about his short life here: http://www.levihicks.blogspot.com

Hi, excuse me, but I’m a physician and there is no such thing as a birth that “poses no risk to the mother.” Before “modern” medicine, childbirth was the leading cause of death for women, and still is in way too many places in this world.
But that’s not my main comment. At age 40, I gave birth to my first child – a desparately wanted girl. Only, at my 3rd ultrasound, I was told, my girl would live not on this earth, but only in heaven. Heart and brain defects incompatible with life.
My OB advised “abortion”, but that was not what I wanted at all. I wanted to surround my daughter with her mother’s love, and I did, I held her in my arms and caressed her little body. She never took a breath.
I was on an internet support group at the time, and the love of the women posting surrounded me and carried me through this nightmare. The choice I made was not something that everyone could face. Some posted of travel to KS, to Dr. Tiller, and told of the amazing love and empathy they received at his clinic.
So, to those who have never lived through this hell, to those who yell at women as they try to enter a clinic, imagine that the woman in front of you wants her baby to live more than anything in this universe – but God himself, in his ultimate wisdom, has already made a different decision. Because those are the women that Dr. Tiller was brave enough and noble enough to minister to.

You claim to be a physician, yet you misspelled “desperately…”
What birth defects — which are incompatible with life — elude two ultrasounds but are revealed by a third?
I feel the same level of skepticism about all the new-found stories of pregnant women deciding to abort their defective children late in the pregnancy.
Tiller was bound by Kansas law to perform third-trimester abortions only in cases where continued pregnancy would likely result in death or severe bodily harm … to the mother. There was no loophole for birth defects, making their presence in this argument a moot point.

You write: “If the baby is going to die but giving birth poses no risk to the mother, it may be that the law needs to, reluctantly, err on the side of fetus.” I would say that losing a child is one of the most tremendous losses a woman or family could ever suffer, and in these horrible situations I would trust the woman over the government every single time when it comes to making these fragile and heartwrenching life and death decisions. Many women who went to Dr. Tiller felt that he allowed their baby to die with dignity, many had been handled inappropriately by the medical staff in their own communities who may have had their own “moral” qualms about the decision to end a terminal pregnancy, many were able to save their fertility because they had a safe procedure rather than carry to term a pregnancy that could deny them the chance to try for children in the future. When it comes to these intimate nuances of women’s hearts and children’s lives I loathe to think of it as a political football, to be decided by elected officials rather than physicians and the women who are most affected.

Skeptical, writing stuff like “You claim to be a physician, yet you misspelled ‘desperately…'” is really, really lame. But if you want to play that game, explain to me how birth defects are imbued with the ability to “elude” detection unless you’re really persistent in finding them. You make it sound like a test of skill, a video game, some kind of tactical behavior, instead of what it is: part of a grieving parent’s narrative. You mock her and call her a liar. You must have a heart of stone.

My first baby was diagnosed with anencephaly and we had an abortion at about 20 weeks. I think it was the hardest thing I’ve ever done in my life. But, to carry the my baby around for another 20 weeks, to even consider possibility that my baby’s short life would be only suffering, was unbearable. My second baby is completely healthy, and that is a great gift, and the greatest joy. But nothing ever erases the memory of my first baby. There’s just a sadness that will always be there.
I wish this situation would never have to be considered. I’ve carried this alone for about ten years till now. I hope that anyone else who has to go through this will have counselors or some other type of support to help them. But what I really wish is that no one is ever in this situation or has to make this decision.

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